Yet,
we humans constantly emphasize the importance of planning. I am going to be an
early advisor that planning for next year, 2016, is best done with preparation
not planning. Here’s why.

Preparing
is getting ready. It is training. Getting into shape. Practicing. Anticipating,
yes, but doing so with the full knowledge that every eventuality cannot
be planned for. Preparing means what you DID in the past to get ready for the
future. It is an inward looking endeavor.

Planning
is also anticipatory, but has an aspect of predicting the future in it. It is
externally focused. If planning determines your course, it is of value as long
as you are flexible. If it simply paralyzes you to real action, caught in thought
as events unfold around you in unanticipated ways, then planning is of little
use. If planning is what you DO and how you DO it, it’s great. If it is about
what you WILL DO, but DON’T, not so much.

How
do we prepare for the Presidential election knowing already from the phenomenon
that is The Donald, that all the planning in the world would not have gotten us
here, where we are, today. The smart planners 6 months ago had a rematch of
1992’s Bush-Clinton battle with the surrogates being a wife and a son. Well,
that looks about half right now and even that may not be correct as she could
lose, he could win, or who knows what?

Our
preparation ought to be keeping up with the issues, knowing the candidates’
positions, voting in caucuses or primaries and being aware.

The
world is a far more complicated place than Mr. Trump would have us believe it
is. He makes governing sound easy. It is not. And he knows better. He’s a bully
and a blowhard, which does not alone distinguish him in this field of GOP
pretenders. He’s a shameless promoter who the media cannot seem to get enough
of and so, while vehemently denying it, the press and media have made The Donald, The
Donald and have only themselves to blame. You want less Donald? Turn off the TV
when he comes on.

As
for the rest of the GOP field, I have confidence that once people actually
decide by caucusing or voting, this will sort itself out to either a shift from
2008’s and 2012’s candidates to a true conservative or a shift from 2008’s and
2012’s candidates to a likeable competent candidate rather than an old guy
telling you to get off his lawn or a rich guy with a car elevator and a dancing
horse. However, I am prepared for either, for neither or for a lot worse.

On
the Democratic side, this is probably over. The Dems’ biggest concern is that
the total polling for its candidates place 99% of the votes in the wrinkled
hands of people eligible for Social Security and Medicare. Not exactly a youth movement. Thus, look for a younger
man to accompany Hillary to the DNC convention podium, one of the Castros (Joaquin
or Julian, not Raul or Fidel), Sherrod Brown of Ohio or maybe a Governor if
there are any Democrats left in the state houses.

Shifting
closer to home, what would be a good strategy for preparing for 2016 at MD
Anderson?

Surely,
the upheaval among department chairs and Division Heads is probably done as
there are so few left from 4 years ago. If you start firing the folks you
hired, you are probably next. (From my blog to God’s ears.) There is no chance
that there will be a climate change in any climate survey done to assess the
morale of the faculty. Beaten into submission says it best. Sooner or later all
the scientists will be working for Dr. DePinho and most of the clinicians will
be relatively inexperienced compared to the group of faculty members patients
used to flock to see at Anderson. I would plan for more of the same.

The
Chancellor has gone back to sleep or rang the bell preferring to concentrate on
acquiring land in southwest Houston for yet another project that smells like
commercialization of academia to me. I am sure that the TMC, MD Anderson,
Baylor, and Methodist will continue to try to turn what was once scientific data for the
public good (often paid for by that public with NIH grants) into fungible income for
their private use. These developments are almost guaranteed. Plan for them.

What
would I do to prepare if I were still on the MD Anderson faculty? Buff up the
old resume.

I
really cannot see what distinguishes MD Anderson from the rest of the goodness
knows how many cancer centers that exist in Houston from Methodist, to Baylor, to
St. Luke’s, to Hermann, to Kelsey-Seybold, to Texas Children’s, to Texas Oncology, to
Cancer Treatment Centers of America (not even in Texas but marketing here with
the smiling face of an ex-MD Anderson faculty member. I see why he’s smiling.)

It
is simply beyond the pale of any strategic planning to claim to be the best and
also the biggest. Michael Porter says so. So does every textbook in strategic
planning. Pick your strategic plan and then prepare for it by having people and
facilities able to deliver on the plan.

I
was once certain this was MD Anderson. I am less certain today. Personally, I’d
sell MDACC short if I could.

Again, you address a crucial point: the inability of the faculty to engage in any meaningful pushback. Tenure is dead, faculty governance is dead, private practice is dying. The result: physicians have become employees with no more rights or protections than those at Home Depot or Walmart. So the current health care model is doomed to fail and physicians no longer control any aspect of it, yet where is the outrage? Where are the calls for unionization? The same can be said for researchers: they are increasingly being required to generate their own salary, which severely limits their academic freedom and, in my opinion, will limit innovation, yet not a peep. I envision your editorial as not only an astute commentary, but a call to action! Oh, and Happy New Year.

I try, but I have found that academics and doctors do not do team sports particularly well. When I was working in Congress, the docs were the least effective lobbyists because no 2 groups wanted the same thing, so they could all be readily ignored by the staffers. The key on Capitol Hill is the brief "ask." What are you there for? What do you want? The docs were notoriously bad at the ask and so they got the dregs. The same is true at MD Anderson. It has shocked me that the clinicians would put up with so much abuse, but clearly they will. Astonishing! HNY. LZ